The Professional Association for Transgender Health
Aotearoa (PATHA) condemns today’s decision from Minister
for Health Simeon Brown introducing a ban on new
prescriptions of GnRH analogues (puberty blockers) for
transgender children and young people who are not currently
on them. This ideologically driven ban will have a
devastating impact on the lives and wellbeing of our
transgender and gender diverse young people.
We know
that children, young people and their whānau will be highly
distressed by this decision. We also acknowledge health
professionals’ frustration at the way their expertise has
been ignored and disregarded.
“The ban will lead to
a deterioration in mental health, increased risk of
suicidality and increased dysphoria in gender diverse
children and young people, and will put them at a higher
risk of experiencing marginalisation and discrimination,”
says Dr Elizabeth McElrea, GP specialist in gender affirming
care and PATHA Vice-President. “The prescribing of puberty
blockers is always undertaken with the utmost care and
consideration. They have been prescribed safely for decades
for transgender children and banning their use will lead to
profound distress in this already vulnerable
group.”
This decision is not supported by the
Ministry of Health’s November 2024 evidence brief on this
care. While the evidence brief identified some limitations
in the academic quality of evidence regarding the risks and
benefits of GnRH analogues, limitations in evidence quality
are common across a number of areas of medicine, especially
within paediatric medicine, and do not justify a ban on
access.
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“PATHA supports evidence-based medicine,
which consists of three key components: academic evidence,
clinical experience, and patient preferences and values,”
says Dr McElrea. “When the quality of available academic
evidence is of lower quality, it’s incredibly common for
clinicians to lean on guidelines drawn from clinical
experience.”
“Practising medicine, and paediatric
medicine (not just within gender affirming healthcare),
often necessitates providing care without a high-quality
evidence base. The absence of high-quality clinical evidence
does not mean providing this care is
wrong.”
“Children benefit from innovative
medical treatments that improve their survival and quality
of life. Pediatric care would all but cease if physicians
denied treatments for which the evidence base is
imperfect.” (McNamara et al., 2024, p. 15) ‘An
Evidence-Based Critique of “The Cass Review” on
Gender-affirming Care for Adolescent Gender
Dysphoria.’
The new restrictions will be in
place until the conclusion of clinical trials in the United
Kingdom, which are not due until at least 2031.
“In
no other area of care would life-saving medication be
withheld from a vulnerable population for six years. This
will have a traumatic impact on a generation of transgender
children,” says Avery Zavoda, PATHA Executive Committee
member.
PATHA is strongly against the decision. It is
a shocking act of discrimination against transgender
children and young people.
“That New Zealand First
announced this news three hours before the Minister of
Health shows the way this care has been politicised, and how
politics have been prioritised over the wellbeing of New
Zealand children,” said Zavoda.
“Banning puberty
blockers will not prevent children from being transgender,
despite the disinformation New Zealand First are
promoting,” says Jennifer Shields, PATHA President.
“It’s obvious that this has been a political decision
made to appease a coalition partner based on an imported
culture war, rather than a medical recommendation reflecting
the expertise of NZ clinicians and researchers who have been
working in this field for over 25
years.”
Identify, a 2022 New Zealand research
survey on the experiences of rainbow young people showed
“the proportion of young people who wanted puberty
blockers and were able to use them was nearly half the
number of young people who wanted these medications but
could not access them.” These findings made it clear that
the prescription context and existing regulations “did not
result in the easy access to young people who wanted puberty
blockers that some people have claimed existed. In fact, the
results demonstrate a seriously constrained prescription
context that urgently needs further attention to be more
equitable.”
“We call on the Ministry of Health to
publish their consultation report immediately, so that
health professionals, trans people, and the wider public can
see that this decision has been made by politicians rather
than based on clinical experience,” says Shields. “We
also look forward to the Minister now immediately allowing
the updated guidelines for gender affirming healthcare to be
published.”
“We also call on Labour, the Green
Party, and Te Paati Māori to commit to reversing this
harmful decision if they are elected into government next
year. Our communities need the reassurance that this ban
will not last,” says Shields.
PATHA is committed to
ensuring all trans children and children experiencing gender
dysphoria have access to the best quality care. Tonight
we’re thinking of the trans children, young people and
their whānau who will be feeling shocked and scared by this
announcement. Tomorrow, we’ll be seeking legal advice
about the options available to us and to families affected
by this decision. Your children have a right to healthcare.
For the government to announce this on the eve of
Transgender Day of Remembrance is an act of
cruelty.
Additional information
In April
this year a number of health professional bodies signed an
open statement supporting the use of puberty blockers for
gender affirming care. Signatories include the Aotearoa New
Zealand Association of Social Workers, Ara Taiohi, Auckland
Sexual Health Service, AusPATH, the College of Child and
Youth Nurses, the New Zealand College of Clinical
Psychologists, the New Zealand Medical Students’
Association, the New Zealand Paediatrics Society, the New
Zealand Psychological Society, the New Zealand Sexual Health
Society, the New Zealand Society of Endocrinology and the
Society of Youth Health Professionals Aotearoa, who all
called on the government to uphold equitable and
evidence-based access to this care. The letter states that
decisions about prescribing puberty blockers should continue
to be made collaboratively between young people, their
families or support people, and the health professionals
involved in their care and that medical decisions should
remain free from political interference.
In May, over
500 medical bodies, professionals, and individuals signed an
open letter calling for the publication of updated
guidelines for gender affirming care, which were finalised
in March 2025 but were blocked from publication by the
Minister of Health.
In October, leading Australian
clinicians working in the field of transgender health
released a joint statement outlining methodological and
ethical issues with the Cass Review, and its limited
applicability to care in Australia.
Earlier this year,
new German, Swiss, and Austrian consensus-based guidelines
were published recommending continued access to gender
affirming care, including puberty blockers. Last year, new
endocrine guidelines published in France also recommended
continued access to
care.
